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General NPI Number Information
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NPI Number | 1881482594
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Entity Type | Individual
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Provider Name | SHENEILLE BURKE HIS
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Gender | Female
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 4112 AVENUE U
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City | BROOKLYN
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State | NY
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Zip | 11234-5120
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Country | US
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Telephone | 718-252-4244
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Fax |
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Provider Business Mailing Address
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Address Line | 6926 DE COSTA AVE
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City | ARVERNE
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State | NY
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Zip | 11692-1116
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Country | US
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Telephone | 516-297-4704
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 14000079545
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License Number State | NY
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